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PUBLIC RECORD OFFICE, LONDON

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16 February, 1920.]

COLONIAL MEDICAL SERVICES COMMITTEE.

DR. 0. M. PRICHARD,

to do anything. Eye work too, is a very important thing.

3068. And the D.P.H.?—I think that is essential for the Medical Officer of Health, yes.

3089. Any officer may be appointed Medical Officer of Health, may he not?-Yes; hitherto I do not think they have insisted on the Medical Officers of Health having the D.P.H,

3090. What was your commencing salary when you joined the Service?—I started at £400.

3001. And what did you rise to?-By £25 I rose to £500, and then, in 1919, I became Senior Medical Officer.

3092. On what scale?--I got £600 then.

3093. £800 fixed?—With a duty allowance of £50. Of course, when I come home on leave I drop my duty allowance.

3094. But no annual increment; a fixed salary?— No, that is all, Sir.

3093. That was in 1913?-1913,

3096. Then, when the war broke out, you went on military service?-I drew my ordinary colonial pay. 3097. And you are still on the £600?--No, not now; we have had our pay increased. I now draw £750.

8008. Has the recent increase of pay rendered Medical Officers contented?--No, it has not.

3099. On the point of pay?-It has made them more contented, but they are not absolutely con- tented,

3100. One thing you say is that they think they should draw higher salaries? I think they should draw higher salaries.

3101. And then what other points; there is the study leave? The study leave, and also there is no promotion in our service.

3102. Well, you have to wait for the promotion of a senior? There has been no age limit for retire- ment and there are no opportunities for transfer to another Colony.

3103. Surely there is an age limit for retirement, is there not? I do not think so; you can go, I believe, at 50.

3104. 55 is the usual age?-50 in East Africa. 3105. Sir Harry Verney: Are there any over 60 there? No, Sir, there are not,

3108. Chairman: May not that be due to its being new service, a temporary state of affairs? Yes, Sir, but I think 20 years' service in any corps is a very long time; do you not think so?

3107. It speaks well for the Colony if promotion is very slow-A great many drop out of it.

8108. Does not that give promption?-No; it is

the juniors who drop out, not the seniors.

3109. That is unfortunate. Are there any other points that cause discontent?-Well, of course, we have suffered during the war from laol of personnel. That is one thing, and naturally our organisation has suffered very much indeed. For example, the Medical Officer in charge of a native hospital in Nairobi looks after the jail, he looks after the lunatic asylum, and he looks after the police, and instead of being able to devote his attention to one branch, he cannot do anything efficiently. That sort of thing, I think, is not conducive to good professional work.

3110. Under war conditions, it is difficult?--Of course, we suffer from a lack of money.

3111. A lack of money?-Lack of funds.

3112. Do you consider the type of Medical Officer in the Service satisfactory? What do you mean by that, Sir? For example. we have not heen getting any permanent men lately; you mean the men in the Service at pre-ent!

8113. I menn the men who have been persauently ruited?-I think he is average, yes,

3114. And the temporary men?Ves, they wora very much the same: the same type of men that you wee going into the R.A.M.C. or the Indian Medical Service. But we had great difficulty in getting tem- porary meu although we offered them a higher scale of pay.

We offered them £600 and a passage home for a year's duty and we have great difficulty in getting them.

[Continued

3115. What scale of salary do you think would attracts sufficiency of good recruits to the East African Medical Service? Well, that is a very diffi- cult question, because I think one would have to compare it with other services. Do you not think so? The pay of the R.A.M.C. and the Indian Medical Service?

3116. Yes. Taking into consideration the climate and climatic conditions.

3117. Yes. And then again the rupes, it is really a very difficult question.

3118. That has been discussed in The Times re-

cently F-Yes.

3119. I gather that you are in favour of making the whole of the East African Medical Officers into one Medical Corps like the West African Medical Service? Yes, I think that would bo a very good ideg, sir.

3120. Do you see any difficulties in doing that?— No, I do not, as regards Uganda, Nyasaland, and East Africa, Zanzibar, but I am not sure about Somaliland,

9121. Do you see any disadvantages in it; you may see many advantages; do you see any disadvan tages? Looking at it from a broad point of view, I do not see any disadvantages; looking at it from the good of the service, I do not see any disadvan- tages.

3122. Sir James Fowler: Do you think it would be an advantage, if men who had shown special capacity in medicine, surgery, ophthalmology, and other special subjects, were given special appointments in connection, we will say, with the largest hospital in the colony, and continued in that work, with increasing salaries, up to just short of the highest attainable P-I think it would be excellent, sir. think the grading of these posts would be an excellent thing and would stimulate the medical work in the colony very much indeed.

I

3129. You would agree that the existence of such a special hospital staff would have a good effect on all brought into contact with it?-It would, certainly.

3124. Such men should be selected from the ser- vice? From the service, yes.

8125. There are great opportunities for research there? There are, sir, yes,

3126. Would You bo in favour of having a research service?--What do you imply by a search service?

To

3127. I mean a service of men devoted to research having shown a capacity for research work. Is that apart from the ordinary personnel of the medical men of the Colony, or part of the staff of the Colony?

3128. Not necessarily part of the staff of the Colony. I see; entirely apart.

3129. It might be so.-Oh, yes, I think it would be an excellent thing.

3130. Is there in East Africa any instituto where research is carried on?-We have a Government Bacteriologist. He is comparatively junior, but he is paid at the same rate of pay as I am; he ranks as a Senior Modical Officer Apart from that, there is nothing.

3131. Ta there attached to the hospital at Nairobi a good clinical laboratory?—No, sir.

3132. T hospital?

thero A efinical laboratory?-At the

3133. Yes.--No, sir.

3124. None?—No; Wo have the Government Bacteriologist who examines our slides for us, or we do it ourselves, and deal with other specimens. He des that for us, but he is not attached to the hospital: he drea' work for every medical officer in the colony.

3135. Have you been at Dar-es-Salaam?--I have only passed through; I had to hurry on.

3196. You feel the want of more rapid promotion in your service?--Yes, we do, and that is one of the grievances. There is no age limit for retirement.

3137. You desire more opportunities for transfer? -For transfer, yes, sir.

3138. At the top of the service or at the bottom. or intermediate? At the top of the ferrico, I think.

16 February, 1320.]

MINUTES OF EVIDENCE.

DR. O. M. PRICHARD,

31:19. Chairman: Would you be willing to go to West Africa?Yes, sir, on promotion.

3140. Moderate promotion?-Moderate promotion, yes, certainly, air,

3141. You have no dislike to the idea of serving in West Africa? Oh, no, I have not any.

3142. Sir Harry Verney: Is there anywhere you would not be willing to go on promotion? No, nowhere, sir.

3143. You have no objection to people coming from outside and taking the senior posts in East Africa; that is the corollary? If I go to a worse colony on promotion.

3144. They may come from a worse colony to your service?--Yes.

3145. That is understood?—That is understood, but I am speaking for myself.

3148. Supposing you were not the person to get the promotion, but one of your colleagues was pro- moted to Ceylon, you would be prepared for someone to come from British Guiana to take the peat you thought you were to get in East Africa; that is tho corollary? Yes, it is.

8147. Does not the question of the language come in; you say he should learn Swahili; a man coming From the outside? Swahili is a language that an ordinary medical officer can acquire in three months, quite enough to carry on; not able to talk highly grammatical Swahili, but colloquial Swahili.

3148. On the question of combining all East Afrion into one service, would you like to include all tropical Africa in that service, the West African Service as well?-Speaking for myself, I should.

3149. Are there any difficulties?--There must be difficulties, financial difficulties and various others, but I think, for the good of the service. that it would tend to raise the tone and prestige of the Colonial Medical Service very much indeed, if they were al! belonging to one service.

9150. The whole of Tropical Africa?-Well, West Africa, East Africa, Nyasaland and Uganda.

3151. Do you not think there would be difficulties about leave and access?--I might think so.

3152. You could not have the same leave for East and West Africa? No, you could not; I think the men would understand that,

3153. About recruiting: you know how the medical officers are recruited to-day in the Colonial Office, more or less by chance?-Yes, they simply write an application, come up here, show that they are fully qualified, go to the Tropical School of Medicine, and then they go out to the various colonies.

3154. Do you know any better way of recruiting? What about competitive examination? Yes, I think that would ba an excellent dea.

3155. Do you think it would be better than the present method?--I think it would.

3156. Do you think there is any age limit on the young side over which a man ought not to be appointed to a tropical appointment; on the young side? On the young side; I do not think he really ought to come out there under 25.

3157. Will you not lose the men whom you would get by competitive examination; will they not all compete sooner than that?-As soon 29 they are qualified they will decide to go into the R.A.M.C.. the I.M.S., or whatever it is, if the Colonial Service were included. In war, they would all have gone into the R.A,M.C., or the I.M.S,

3158. Would you not have lost them?--That is true, but I do not think a man under 25 ought to come out into these places as a doctor.

3159. Just one other question about study leave: would you have your Senior Medical Officers taking it as well? I think so; yes.

3160. You would havo it really right through?— Right through, yen.

3161. So that practically every fifth year the leave would be nine months for everybody?--For every- body. I do not think it would be quite fair to ask a Inau after 10 years' service in the tropics to pass a very stiff examination, but he would have to bring proof that he had worked at study leave.

101

[Continued.

3102. Ntr Humphry Rolleston: So that you would always add on three months' study leave on full pay to the six months which he has for recreation?-Yes, Bir.

3163. And you quite agree to his having to present a certificate to show that he has worked during that leave?--To show that he has worked during that leavo. 3184. Would you make it compulsory that he should take a course, say, for the first 20 years of his service? Yes, I think it should be compulsory ou everyone, all through, to take a course.

3165. It has been suggested with regard to East Africa, or East African territories, that it might be an advantage if a man were continually travelling round? A Director-General.

3186. Yes. That would be a very good idea. He would act as a sort of co-ordinator of the Medical and Sanitary Services in the various Colonies, and establish a definite policy regarding medical and sani- tary matters there. At present there is no policy at all; it generally emandtes from local offices.

3167. Under whom should be be; to whom should he report, to the Governor or the Colonial Office?-- The Colonial Office.

3168. Would you have him communicate straight with the Colonial Office?-I would, straight to the Colonial Office.

3169. It has been suggested that there should be a kind of Director-General who should be, perhaps, mainly stationed in this country, to whom men, like yourself, for example, might come and talk things over, and point out any suggestions for improvement, or even if you had a grievance, that you might con- fide it to him?-I agree to that; I intended to say

that.

or

3170. It is rather difficult to select such a man; whether you would have a man who had served his turn with distinction in the Colonial Service, whether you would have a man, although he was not brought up in the conditions of the Colonial Service, knew medicine generally; which do you think would be most advisable? It is immaterial. If a man could be found in the Colonial Service that had the organising ability, by all means give it to him, but if sonicbody else here had more organising powers, I would be inclined to give it to him. A man should be selected on his merits, I think.

3171 You would not consider a knowledge of tropical conditions necessary? A knowledge of local conditions is necessary.

3172. Not essential?-I should not consider it abso- lutely essential.

3173. B cause he could not have a knowledge of all the local conditions? No, it would not be possible. For example, in peace time the King's African Riftes had an Inspector-General. He lived in England six months, and he came out for six months. It had a most stimulating effect; the idea of being inspected by anmebody coming out straight from home had a good influence.

3174. Do you see any difficulty in his working with the Governors of the respective Colonies? I think the Governors would object to his being in direct cmm nication with the Colonial Office.

3175. Sir James Fowler: Do you say they would" I think they would: I should imagine they would. 3176. Sir Harry Ferney: You would, if you were a Governor-Yes.

3177, Sir Humphry Rolleston: Supposing he came hick from the Colony, and he had some recommen- dation to make, you would suggest, although he was in London, he should first communicate with the Governor---Yes.

3178. Before he asked the Colonial Office to instruct them?--Yes; that might overcome the difficulty.

Sir James Fowler: Why should he not send in duplicate? What about the Inspector-General of the King's African Rifles; did he communicate direct with the Governor or direct with the Colonial Office,

3179. Mr. Fiddian: He would be the direct superior of the Principal Medical Officers? - Yes.